Masalah ginekologi pasien remaja di RSUP Sanglah Denpasar pada April 2016 – Maret 2017

Remaja adalah masa peralihan dari anak-anak ke dewasa atau tumbuh menjadi dewasa. Remaja belum dapat dikatakan sebagai dewasa namun juga sudah tidak dapat dikatakan sebagai anak – anak. Definisi remaja menurut WHO adalah seseorang dengan usia 10-19 tahun. Pada masa remaja ini sudah mulai muncul ciri-ciri perkembangan seks primer maupun sekunder seperti tumbuhnya payudara dan menstruasi pada wanita. Proses perkembangan seks sekunder ini tidak semuanya berjalan dengan lancar pada setiap wanita. Sangat mungkin untuk terjadi masalah-masalah pada proses perkembangan ini yang berhubungan dengan kesehatan reproduksi. Tujuan: Untuk mengetahui masalah ginekologi remaja yang berkunjung di RSUP Sanglah Denpasar. Metode: Penelitian ini dilakukan dengan teknik total sampling untuk mendapat angka kejadian gangguan menstruasi, keputihan, tumor ovarium, Polycystic Ovary Syndrome, infeksi Human Papilloma Virus dan kehamilan yang tidak diinginkan pada remaja wanita yang memeriksakan diri di RSUP Sanglah dalam periode April 2016 – Maret 2017. Hasil: Dari 49 sampel yang didapat terdapat 53,06% kasus keputihan, 38,78% kasus gangguan menstruasi dan 8,16% kasus kanker ovarium. Kesimpulan: Tidak ditemukan pasien dengan infeksi Human Papilloma Virus (HPV), Polycystic Ovary Syndrome (PCOS) dan kehamilan yang tidak diinginkan pada periode April 2016 – Maret 2017. 

Hubungan prematuritas dengan kejadian sepsis neonatorum yang dirawat di ruang perinatologi dan neonatal intensive care unit (NICU) RSUD Wangaya kota Denpasar

Background: Premature neonates have an immature immune system due to the lack of IgG antibodies. These antibodies do not cross the placenta from mother to baby at last trimester that can increase the risk of neonatal sepsis. This study aims to determine the relationship between prematurity and the incidence of neonatal sepsis at Perinatology Ward and NICU Wangaya General Hospitals, Denpasar.

Methods: This research used analytical observation with cross sectional study design from January-April 2018. The samples involved are 50 neonates, admitted at Perinatology Ward and NICU Wangaya Hospital and fulfilled the inclusion and exclusion criteria. Samples were obtained by using consecutive sampling method and using secondary data from the medical record

Result: 23 samples (46%) premature and 27 samples (54%) were not premature, out of 50 samples as many as 20 samples with neonatal sepsis. From the results of hypothesis testing using the chi-square test, the p-value is 0.005, and the prevalence risk was 2.73.

Conclusion: Prematurity is significantly related with the incident of neonatal sepsis at Perinatology Ward and NICU Wangaya Hospital, Denpasar City.

Hubungan antara derajat dehidrasi dengan penurunan berat badan pada anak diare usia 1 sampai 5 tahun di ruangan kaswari dan poliklinik anak RSUD Wangaya kota Denpasar

Background: Children with diarrhea occurrences at ages 1 to 5 years had a prevalence of 16,7% in developing countries. Children suffer from diarrhea more than 12 times per year, and this is also the cause of death by 15 – 34 % of all causes of death. Most of the death from diarrhea due to dehydration begin with dehydration symptoms and decreased body weight. Diarrheal disease cannot be underestimated. Comprehensive, holistic and rational handling is required.

Methods: This study was observational analytic research with cross sectional study design. This study aimed to investigate the correlation between the degree of dehydration with a weight loss of diarrhea children aged 1 - 5 year. The sample is 55 diarrhea children aged 1 to 5 years with dehydration and without dehydration in Kaswari and Clinic pediatric at Wangaya Hospital Denpasar from May until August 2018. The data was analyzed by Chi-Square test

Result: 24 of 30 children aged 1 to 5 years with mild-moderate dehydration diarrhea lose weight (80%), while the other 6 did not lose weight (20%) with p-value = 0,001.

Persentase remaja pengguna rokok pada klien klinik napza di Rumah Sakit Umum Pusat Sanglah Denpasar

Introduction: Smoking is a major cause of preventable death worldwide, and is a major risk factor for six of the eight leading causes of death, namely ischemic heart disease, cerebrovascular disease, lower respiratory infections, chronic pulmonary obstructive disease, tuberculosis and lung cancer. This study aims to determine the percentage of cigarette use, the characteristics of age for the first time smoking, and the percentage of use of cigarettes, alcohol, and other substances in PTRM Sandat clients Sanglah Hospital.

Method: This study was conducted at PTRM Sandat Sanglah Hospital in August to October 2015 using a descriptive cross-sectional design.

Results: The results of this study showed 100% of respondents smoked at a young age with 76% of respondents having a daily smoking status. The data obtained showed that the majority of smoking clients in the age of 13-15 years were 56% and 42% smoked at 16-19 years old. Judging from alcohol consumption, all study respondents consumed alcohol and 74% of respondents consumed marijuana. Of the total respondents, 60% consumed benzodiazepine and 62% of respondents took amphetamines. As many as 66% of respondents took halucinogen drugs and were responsive who consumed opioids by 36%.

Karakteristik pasien dengan infeksi Burkholderia cepacia di RSUP Sanglah pada tahun 2014-2016

Background: Burkholderia cepacia complex (Bcc) is a group of 17 species that are genetically and phenotypically similiar. Bcc is an opportunistic pathogen in which it will cause an infection in a person who has had a previous severe lung infection or a person with a weak immune system.

Objective: This study aims to determine the characteristics of Burkholderia cepacia compleks patients at RSUP Sanglah Denpasar period 2014-2016 Sanglah Hospital.

Methods: This was an observational descriptive study with a cross-sectional study design and a retrospective approach. The subjects were 29 patients diagnosed with Burkholderia Cepacia bacteria and performed bacterial culture at Sanglah Hospital on January 1, 2014 s.d. December 31, 2016. The research data is secondary data obtained from the book Microbiology section Sanglah Hospital.

Results: The results showed that patients with isolated Burkholderia cepacia who were admitted to Sanglah Hospital consisted mostly of 37.9% old age categories (> 50 years) and adults (18-50 years); 65.5% male sex and 34.5% female gender; 62.1% were admitted to the ICU; 24.1% were diagnosed with sepsis;

Karakteristik pasien retinoblastoma di RSUP Sanglah pada bulan April 2015 – Desember 2017

Background: Retinoblastoma is one of the intraocular tumors originate from the lining of the retinal eye layer component. This disease is more common in children. Retinoblastoma incidence rate tend to be constant every year, but epidemiological data about retinoblastoma in Indonesia not yet available.

Aim: this study aims to determine the characteristics of patients with retinoblastoma at RSUP Sanglah Denpasar from April 2015 till December 2017.

Method: The study was a descriptive cross sectional design which was conducted at RSUP Sanglah Denpasar. Data obtained was in the form patient’s medical records registered between April 2015 – December 2017.

Results: Of the 22 patients, the age average was 5.06 ± 3.06 years with the highest gender proportion was male (55%). Leukokoria (68%) was the main complaint. Most sites were unilateral (59%). Staging for unilateral was Group D (47%) and for bilateral was OD Group D, OS Group E (25%) and OD Grup E OS Grup C (25%) There were two patients had family history of retinoblastoma (18%). Histopathological finding showed only 4.54% with typical appearance of Flexner Wintersteiner Rossete, 36% of patients showed pseudorossete, and the remains classified as undifferentiated type. Almost half of the patients have a tumor invation, and most of them have necrosis in their tumor. The most common management for retinoblastoma is chemotherapy (52%) followed by enucleation (48%). Conclusion: There’re variety in characteristics of retinoblastoma. Further research needed to know the characteristic of retinoblastoma significantly.

Tingkat pengetahuan dokter umum mengenai bukti medis kekerasan seksual di RSUD se-Provinsi BALI tahun 2017

Background: Sexual violence is a frequent criminal offense. Targets that become victims of the crimes can be women even today many occur in children. Medical evidence is the key to the proof of a case of sexual violence that is usually made by a forensic specialist. A general practitioner is expected to be able to examine the medical evidence of sexual violence considering the number of forensic specialists who are not comparable with the geographical area of Indonesia.

Aim: The study aims to know the level of knowledge and relation between the variable of age, practice experience, and level of education related to the knowledge level of general practitioners about medical evidence of sexual violence.

Method: This study is descriptive cross-sectional research located at Emergency Department all over General Hospital in Bali Province. The subject is general physician ≤60 years old. Data obtained use questionnaire containing a set of questions.

Result: The results showed the general practitioner knowledge level about medical evidence of sexual violence was good. Of the 110 samples, 87.3% had a good level of knowledge, 11.8% was sufficient, and 0.9% had less knowledge level. One variable influenced the general physician's knowledge level was practical experience (p = 0.039). Moreover, the age (p = 0.908) did not have a significant relationship to the general practitioner knowledge level about medical evidence of sexual violence.

Conclusion: It is essential that practical experience for a doctor's knowledge level about medical evidence of sexual violence is critically important.

Gambaran pengetahuan, sikap, dan perilaku tentang vaginal hygiene terhadap kejadian keputihan patologis pada siswi kelas 1 di SMA Negeri 1 Denpasar periode Juli 2018

Introduction: Leucorrhea was a prolonged problem that has been experienced by women, especially teenagers. Teenagers are part of a population that are at risk. Pathological leucorrhea which is not prevented and handled properly can cause various disease and have a fatal end. This research aimed to know how were the knowledge, attitudes, and behavior of vaginal hygiene towards pathological leucorrhea phenomenon on first grade female students in 1 Senior High School of Denpasar City.

Method: This research was a descriptive study with cross-sectional method. The research subject was 106 first grade female students in 1 Senior High School of Denpasar City. The data were collected on 26^th of July 2018. This research used primary data from the questionnaire that had been filled out.

Result: The results showed that the level of knowledge about vaginal hygiene was 99,9% good and 0,1% bad. The level of attitudes about vaginal hygiene was 100% good. The level of behavior about vaginal hygiene was 98,2% good and 1,8% bad.

The risk of atopic dermatitis in post-term gestational age at Sanglah Hospital Denpasar: A preliminary study

Backgrounds: Several studies reported that Atopic Dermatitis (AD) increases with gestational age. Prolong dominancy of Th2 activity during gestation might contribute to the risk of atopic disease in infancy or beyond the period. This study aimed to evaluate the risk AD in post-term gestational age.

Methods: A prospective observational study was conducted among 73 living births at Sanglah Hospital Denpasar from December 2015 to January 2016 period. Infants were classified into 2 such as exposed (post-term) and non exposed (term and preterm) group. Parents-follow up by phone was carried out in 1 until 2 months interval. The study was finished once AD diagnosed, subject died or lost to follow up. Statistical analysis was carried out using SPSS ver. 20 software whereas P-value > 0.05 was considered significant.

Results: About 20 (233%) infants were preterm, 36 (49.3%) a term, and 17 (23,3%) post-term. The median value of follow up duration was 28 (14-35) days. Based on AD, there were total 24 cases which divided into 15(62.5%), 8(33.3%) and 1(4.17%) cases of AD in post-term, aterm, and preterm respectively. The incidence rate of AD in post-term was 88.2% while in non-post-term the incidence rate was 16.1%. The relative risk (RR) of AD in post-term was 5.47 (95% CI 2.94-10.23; P = 0.001)

Conclusion: Post-term is 5.47 times more likely to develop AD compared with aterm and preterm infant. In addition, the incidence rate of AD in post-term infant was 88.2% at Sanglah Hospital Denpasar

Perbandingan efektivitas teknik modifikasi dan konvensional pada operasi open pyelolithotomy batu staghorn

Background: Open pyelolithotomy for staghorn stone patient management has a high stone-free rate. The disadvantages of open pyelolithotomy include aesthetics and postoperative complications, so a breakthrough to reduce these complications is needed, which can be achieved by doing modified open pyelolithotomy.

Objective: To compare the modified and conventional open pyelolithotomy techniques according to the duration of operation, the volume of surgical bleeding, pain, and post-operative drop in hemoglobin (Hb).

Method: A quasi-experimental study with twenty-two samples of staghorn stone patients was collected from October 2016 to October 2017. Parametric tests were used as data were normally distributed and homogeneous. The independent t-test was used to compare each measured parameter according to the type of operation. Analysis of covariance (ANCOVA) was used to control the variables of age, gender, and body mass index (BMI).

Result: The modified technique had a shorter operating duration than the conventional method (p < .05). The volume of surgical bleeding in the modified technique was lower compared to the conventional technique (p < .05). Pain scores in the modified technique were lower than the conventional technique (p <  .05). The drop in Hb levels in the modified technique was lower than the conventional technique (p < .05). Analysis using ANCOVA found that the type of operation has a direct effect on the duration of operation, volume of surgical bleeding, and post-operative pain.

Conclusion: The modified open pyelolithotomy technique was more effective than the conventional open pyelolithotomy technique based on the duration of operation, the volume of surgical bleeding, and post-operative pain scale. In this study, it was found that the drop in Hb levels was not directly affected by the type of surgery.

The prevalence of urinary incontinence in aged women in Peguyangan Village, District of Tag-Tag Kelod, Denpasar, Bali

Background: Urinary incontinence (UI) is a significant health problem with considerable social and economic impact. Distinguishing between prevalence and incidence of incontinence is important. There are significant variations in the severity and impact of incontinence, and its severity, frequency, and predictability all need to be considered when evaluating its effects on patients, the degree of bother is particularly significant when determining who will need treatment. Incontinence may be a result of bladder dysfunction, sphincter dysfunction, or a combination of both, but large-scale studies are not designed to determine the etiology.

Aim: To know the prevalence of UI in aged women in Peguyangan village, Denpasar, Bali.

Method: This is cross-sectional descriptive design conducted in Peguyangan Village Denpasar, Bali, in early July 2017. There were 79 of 94 aged women above 65 years involved in the survey using a questionnaire.

Result: In young women, the prevalence of incontinence is usually low, but prevalence peaks around menopause, with a steady rise there-after into later life. Although the prevalence of stress and mixed (stress and urge) incontinence is higher than urge incontinence, the latter is more likely to require treatment. In women, moderate and severe bother have a prevalence ranging from about 3% to 17%. Severe incontinence has a low prevalence in young women but rapidly increases at ages 70 through 80.

Conclusion: The prevalence is 0.076.

Hubungan suami perokok terhadap bayi berat lahir rendah pada neonatus di ruang Perinatologi RSUD Wangaya kota Denpasar

Background: Low birth weight babies (LBW) are still a problem. The causes of LBW are multifactorial, one of which is exposure to toxic substances (cigarettes). Exposure to cigarette smoke can disrupt fetal development during the womb. Based on studies, active and passive smokers have almost the same level of risk. This study aimed to find out about a smoker's husband as a risk factor for the occurrence of low birth weight babies in neonates at Perinatology Room of Wangaya Hospital, Denpasar.

Methods: Analytical observational research with case-control research design. The study sample was all neonates who were treated in the Perinatology Room of Wangaya Hospital from May to August 2018 and fulfilled the inclusion and exclusion criteria. Based on the calculation of the sample size, 72 neonates were obtained. The sample is determined by consecutive sampling. In this study, data were obtained from medical records (documentation) and questionnaires.

Result: Samples were divided into two groups, namely the case group and controls where each group consisted of 36 samples. As many as 23 of the 36 neonates who were smokers' husbands suffered from low birth weight babies (63.88%), while 13 others did not suffer from low birth weight babies (36.11%). The results of hypothesis testing using the chi-square test, the value of p = 0.03 (p < 0,05, OR = 2,78, CI = 0,091-0,267).

Analisis tingkat pengetahuan mahasiswa program studi pendidikan dokter tahun ajaran 2017-2018 Universitas Udayana tentang prescribing error

Introduction: Prescribing Errors is a failure in the treatment process leading to or potentially harmful to the patient, this error most often occurs although it can be prevented. The incidence of prescribing errors continues to increase from year to year, but data in Indonesia that discusses the level of knowledge of medical students about prescribing errors is still small. The purpose of this study is to determine the level of knowledge of medical student study program 2017-2018 academic year at Udayana University Denpasar about prescribing errors.

Method: This research is a descriptive cross sectional study conducted at the Medical Faculty Udayana University Sudirman Campus Denpasar. Data obtained in the form of primary data questionnaire. Data were analyzed using software computer.

Result: The results showed that the most gender are women of 68 students (66%). The largest proportion of age is 19-20 years old number of 52 students (52%). Groups of semesters 1, 3, 5 and 7 obatined a similar proportion of 25 students (25%). The level of students' knowledge of prescribing case study is classified into moderate category with mean 3,7-7,1 of 67 students (67%). The number of correct answers in identifying type of error from 3 prescriptions is in the case of the first prescription, the 3rd semester student who is able to identify the prescribing error, with the type of mistake that is wrong dose as many as 14 students (35,9%) with p value = 0,066 and wrong dosage form as 21 students (39,6%) with p value = 0.000. In the case of the second prescriptions, 7th semester students were able to identify the prescribing error, with the type of mistake that is wrong dose as many as 13 students (41,9%) with p value = 0,005 and wrong dosage form as 22 students (36,7%) with p value = 0.000. In the case of the third prescriptions, the 3rd semester students were able to identify the prescribing error, with the type of mistake that is the wrong indication of the drug as many as 15 students (62,5%) p value = 0.000.

Hubungan profil lipid dan C-reactive protein (CRP) dengan derajat stenosis koroner pada penyakit jantung koroner stabil

Background: Inflammation and dyslipidemia play an important role in the formation of atherosclerotic plaques in stable coronary artery disease (SCAD). The stenosis degree indicates a visual evaluation of the percentage reduction of coronary diameter compare to normal coronary. This study aims to determine the correlation of lipid profiles, CRP with the stenosis degree in SCAD.

Methods: Cross sectional study was carried in 31 patients with SCAD who had coronary angiography at Dr. Kariadi. The study used secondary data from February - March 2018 at Dr. Kariadi Semarang. Secondary data included levels of total cholesterol, LDL, HDL, triglycerides and CRP. The stenosis degree was obtained from coronary angiography in percentage units. Statistical analysis used Spearman Correlation test, p < 0,05 was considered significant.

Result: Median (min-max) levels of total cholesterol, HDL, LDL, triglycerides, CRP and stenosis degrees respectively are 156 (104-283), 41 (13-67), 102 (60-190), 116 (60- 216), 1.50 (0.50-6.54), 70 (20-100). Correlation of total cholesterol, HDL, LDL, triglycerides and CRP levels with a degree of coronary stenosis are (r = 0.123; p = 0.511), (r = -0.132; p = 0.479), (r = 0.073; p = 0.697), (r = 0.117; p = 0.531), (r = 0.026; p = 0.891).

Conclusion: There are no significant correlation between lipid profiles, CRP with stenosis degree in SCAD. The effect of statin drugs has an effect on dyslipidemia and as an anti-inflammatory.

Uji korelasi leukosit esterase dan nitrit dengan kultur urin pada infeksi saluran kemih

Background: Urinary tract infection (UTI) is a condition where the urinary tract is infected by pathogens, causing microorganisms in urine. The gold standard examination for UTI is urine culture. Urine culture has some weaknessess. It takes around two days to get result and requires quite expensive cost. Leukocyte esterase and nitrite are relatively inexpensive, less-time consuming and easy to do laboratory tests that can detect UTI.

Aim: To explore the correlation of leukocyte esterase and nitrite with urine culture in UTI patients.

Methods: A cross sectional study of 42 UTI adult patients which treated at Dr. Kariadi hospital Semarang in September until October 2018. Combur dipstick using colorimetry method and urine culture using convensional method. Correlation test analyze using contingency coefficient.

Results: The correlation analysis showed there was a positive correlation between urine esterase leukocytes with urine culture (p = 0.044 and r = 0.152) and there was no correlation between urine nitrite with urine culture (p = 0.272),.

Conclusion: There was a correlation between urine leukocyte esterase and urine culture and there was no correlation between the urine nitrite to urine culture. However further researches are needed to analyze factors that affecting the UTI diagnostic.

Culture results on chest tube thoracostomy water-sealed drainage in patients with pneumothorax at Sanglah General Hospital, Bali-Indonesia

Introduction: Thoracic trauma is one type of trauma with a high incidence that causes morbidity and mortality after head trauma and extremity. The act of installing a thoracostomy has become one of the standard management of thoracic injury. Infection is a complication that can occur during treatment. This study aimed to provide an overview of the results of thoracostomy tube water-sealed drainage (WSD) culture in pneumothorax patients at Sanglah Hospital.

Method: The study design used a cross sectional descriptive method. The subjects of the study were blunt thoracic trauma patients with pneumothorax who came to the emergency department of Sanglah Hospital to indicate the installation of a thoracostomy hose during the period January to December 2018.

Results: From 40 study samples there were 32 subjects with positive culture results, then from all subjects with positive culture results found 10 people (25%) with culture results of staphylococcal aureus bacteria, based on rib fractures more samples with rib fractures less than two bones ( 62.5%), based on the duration of WSD installation there were more samples with the duration of WSD installation more than 7 days (75%).

Conclusion: The high positive culture results which are dominated by pyogenic skin bacteria, namely Stapylokokus aureus is a challenge for surgeons in managing the complications of tube thoracostomy (TT) installation in patients with pneumothorax.

The relationship between neutrophil to lymphocyte ratio (NLR) at admission and GRACE mortality risk score in acute myocardial infarction patient at Tabanan Regency Hospital in 2017

Background: This study aimed to investigate the role of neutrophil to lymphocyte ratio (NLR) as non-specific and independent laboratory biomarkers when associated with Global Registry of Acute Coronary Events (GRACE) mortality risk score in predicting the morbidity and mortality of patient with acute myocardial infarction (AMI).

Methods: A cross-sectional study design among 103 AMI patients who met inclusion criteria were enrolled in this study. NLR was the ratio of absolute count between neutrophil and lymphocyte. In addition, the GRACE score was a valid instrument in evaluating acute coronary syndrome (ACS). Data were analyzed using SPSS software version 17.

Results: Correlation test showed a weak positive correlation between NLR value and GRACE risk score (r=0,388; p<0,05). Bivariate comparative analysis showed that there was a significant difference in NLR mean in GRACE score group (F (2,100) =5,215, p=0,007). Using the least significance different, it was found that there was a significant difference of NLR mean between low and high GRACE score group {(p=0,003; 95% CI =-3,556 – (-0,736)}.

Perbedaan kadar antitrombin III pada sepsis neonatal kultur darah positif dan kultur darah negatif

Background: Fetal and neonatal hemostatic systems are dynamic. Coagulation and inhibitors of coagulation factors are progressively synthesized by the fetus which begins after 34 weeks of pregnancy and at the initial hours after birth. The neonatal hemostatic system generally shifts towards hypercoagulability. During sepsis, this hypercoagulability is exacerbated by an imbalance of coagulation and inhibitors of coagulation factors including antithrombin III. This study aimed to determine differences of antithrombin III levels in neonatal sepsis positive blood cultures (proven sepsis) and negative blood cultures (unproven sepsis).

Methods: The subjects of this study were 26 patients of neonatal sepsis, which consisted of 13 positive blood cultures and 13 negative blood cultures. Levels of antithrombin III were examined by chromogenic methods. Examination of blood cultures of gram-positive bacteria using manual method and gram-negative bacteria using semiautomatic method. Data analysis uses an independent t test.

Results: Antithrombin III levels in neonatal sepsis patients positive blood culture (73,23 ± 21,62) didn’t differ significantly compared to negative blood cultures (65,63 ± 20,81) with p = 0,370 (p> 0,05). The bacterial pattern that caused neonatal sepsis were Staphylococcus sp. (84,6%), CoNS (81,8%), Staphylococcus aureus (18,2%)}, Salmonella spp (7,7%) and Klebsiella pneumoniae ssp pneumoniae (7,7%). The sensitivity pattern of Staphylococci to cefoxitin to determine resistence, found 5 Methicillin-resistant Staphylococci (MRS) and 1 Meticillin-resistant Staphylococcus aureus (MRSA).

Hubungan resting metabolic rate (RMR) dan komposisi tubuh dengan kadar HbA1c pada obesitas

Background: Obesity occurs due to an imbalance intake and energy expenditure. The cause of obesity is low energy expenditure whereas the resting metabolic rate (RMR) is the largest component of energy expenditure of the body. The factors that influence RMR are body composition, age, sex and hormonal status. Body composition measured as fat mass and free fat mass (FFM). Body fat increase in obesity can cause insulin resistance which will increase blood glucose levels. This study aims to determine the correlation between RMR and body composition (fat mass and FFM) with HbA1c levels increase as a parameter of diabetes mellitus in obesity.

Methods: Cross sectional study design to 38 subjects young adults obese. Resting metabolic rate and body composition (fat mass and FFM) measured with Omron Karada scan HBF 375. HbA1c measured with ion-exchange HPLC method. Statistical analysis using the Spearman’s correlation test (p<0.05)

Result: HbA1c mean of 5.4% is still a normal value of HbA1c. There were no correlation between RMR and HbA1c (p = 0.768), fat mass with HbA1c (p = 0.102) and FFM with HbA1c (p = 0.843).

Conclusion: RMR and body composition (fat mass and FFM) are not associated with HbA1c levels in obese young adults.

Hubungan jenis packed red cell (PRC) yang ditransfusikan dengan reaksi transfusi febrile non haemolytic transfusion reaction (FNHTR)

Background: One of the components of blood cells are often used for transfusions is Packed Red Cell (PRC). Blood components transfusion may continues with rapid or delayed transfusion ractions. The most transfusion reactions  was fever (55%) or febrile non haemolytic transfusion reaction (FNHTRs). The cause of these events is associated with allogenic leucocytes (the ability to differentiate self cells and non-self cells based on the human leukocyte antigen (HLA) on the cell surface) and release of proinflammatory cytokines such as IL-1, IL-6, IL-8, TNFα, Cell-free DNA (cfDNA), histone and the duration of blood storage.

Methods: Cross-sectional study on 41.177 patients who received a PRC transfusion with the FNHTR transfusion reaction in Hospital Blood Bank Dr. Kariadi Semarang, during  January 2017 to July 2018. Pearson Chi Square test for expected frequency more than 5. The Kolmogorov smirnov and Shapiro-wilk test were used to evaluate normality of the data. Mann-Whitney test to analyze the difference, p < 0,05 was considered as significant.

Results: The incidence of FNHTR was lower in patients who received leukodepleted PRC (11 patients) than non leukodepleted PRC (124 patients). There were differences in body temperature in the incidence of FNHTR between the two groups 38.1⁰ C (38-39) VS 38.4⁰ C (38 – 39.2) with p = 0,046.

Conclusions:There were relationship between the incidence of FNHTR with the transfusion with leukodepleted PRC and non leukodepleted PRC.

The correlation between serum magnesium level and blood pressure in patient with chronic kidney disease

Background: Increased blood pressure is one of the complications from hemodialysis in Chronic Kidney Disease (CKD) patients. Magnesium is an electrolyte which is a calcium antagonist in regulating blood pressure. This study aims to prove the correlation of serum magnesium level with blood pressure in CKD patients

Methods: A cross-sectional study was conducted on 30 CKD patients in Dr. Kariadi Hospital, Semarang during September–October 2018. The serum magnesium level was measured with spectrophotometry method, blood pressure with a sphygmomanometer. Statistical analysis used Pearson and Spearman correlation test.

Result: There is a significant correlation between serum magnesium level and systolic blood pressure with p< 0,001 and r=-0,737 and correlation between serum magnesium level and diastolic blood pressure with p=0,011 and r=-0,457

Turnaround time pelayanan darah rujukan di bank darah RSUP Dr. Wahidin Sudirohusodo sebelum dan sesudah implementasi sistem informasi manajemen darah

Background: Blood Information Management System or SIMERAH is the system information which allows blood bank officers at Dr. Wahidin Sudirohusodo hospital to check blood supply in Blood Transfusion Unit. Before SIMERAH implementation, referral blood service was done by directly giving the patient’s family a blood request form to PMI without blood supply information. Referral blood service after SIMERAH implementation requires blood bank officers to order blood before referring patients to PMI. This study aims to compare Turnaround Time (TAT) of referral blood before and after SIMERAH implementation.

Methods: The population of this study has been all patients receiving referral blood service to PMI since January 2017 to June 2017 (before SIMERAH implementation) and January 2018 to June 2018 (after SIMERAH implementation). Statistical analysis conducted were descriptive statistics and paired t-test.

Results: The average TAT at Dr. WahidinSudirohusodo Hospital’s Blood Bank before SIMERAH implementation was 6,10 hours. The average TAT after SIMERAH implementation was 4,37 hours. There was 25,2 % decrease of average TAT after SIMERAH implementation at Dr. Wahidin Sudirohusodo Hospital’s Blood Bank. There were significant decreases of TAT in January, February, March, May, and June (p<0.05). There was a decrease of TAT in April but not statistically significant (p>0.05).

Hubungan antara Chronic Kidney Disease (CKD) dengan hipotiroid di RSUP Dr. Kariadi Semarang, Indonesia

Background: Thyroid hormone in many previous studies have been linked to chronic kidney disease (CKD). There are several interactions between renal dysfunction and thyroid hormones that influence each other. The aim of this study was to see the effect of CKD on the thyroid.

Methods: Cross sectional studies on subject data taken retrospectively by looking at medical records on a single center Dr. Kariadi Semarang Hospital during the period 1 June 2017 – 1 June 2018 to then observe the correlation effect of CKD on thyroid hormones by comparing serum urea and creatinine with T3, T4 and

TSH.

Results: There was a significant correlation of CKD on T3 and TSH levels with ureum (p = 0.020 and p = 0,0,25), and there was a significantly weak correltaion with creatinin (p = 0,081), but there was no significant correlation in T4 (p=0,102; p = 0,108).

Conclusion: The results of this study can be concluded that there is a significant correlation between Chronic Kidney Disease (CKD and hypothyroidism, especially the correltation effect of T3 with ureum and creatinine, and TSH with ureum.

Microbiota-based therapies for chronic kidney disease

Background: Increasing prevalence of chronic kidney disease (CKD) worldwide has been concerned as a global public health issue because of the burden of adverse outcomes, including mortality. Gut microbiota can be used as a potential therapeutic target to slow the progression of CKD.

Aim: This literature review aims to provide an in-depth review about the potency of microbiota-based therapy for CKD.

Method: from 58 journals reviewed, 51 were found suitable as references for this paper. The keywords used are “gut microbiota,” “chronic kidney disease”, “prebiotic”, “probiotic” and “fecal microbiota transplantation” on selected search engines.

Result: In general, it has shown that microbiota-based therapies do have potential therapeutic effect as it can improve inflammatory response, uremic toxin, insulin resistance and cardiovascular risk.

Conclusion: Prebiotic, probiotic, fecal microbiota transplantation and novel therapies have shown beneficial effects in treating patients with CKD.

Pneumotoraks spontan primer berulang pada wanita hamil dengan hiperemesis gravidarum: laporan kasus

Background: Spontaneous pneumothorax is a rare case during pregnancy. However, the condition of Hyperemesis Gravidarum during pregnancy is one of the risk factors for recurrent primary spontaneous pneumothorax.

Case Description: A 28-year-old woman with G5P3013 gestational age 12-13 weeks with Hyperemesis Gravidarum had complaints of tightness and recurrent acute pleuritic chest pain. After a clinical and supporting examination using ultrasound, patients were diagnosed with recurrent primary spontaneous pneumothorax, and observational and symptomatic treatments were performed. The rupture of the bleb or the subpleura bulla is thought to be a pathological mechanism. Patients given birth vaginally without complications and complete resolution of the pneumothorax occurred.

Conclusion: Recurrent pneumothorax in pregnant women with a history of hyperemesis gravidarum is rare. Observational and symptomatic treatment is the initial treatment that can be done.

Laparoscopic pyelolithotomy in treating extra-renal pelvic calculi at Sanglah General Hospital: a case series

Background: This study aims to describe our initial experience in treating extra-renal pelvic calculi using retroperitoneal laparoscopic pyelolithotomy techniques in Urology Division, Department of Surgery, Sanglah hospital, Bali.

Case Description: There were seven patients enrolled with extra-renal pelvic calculi in this study whereas two of them accompanied by calyx inferior secondary stones. All the patients underwent retroperitoneal laparoscopic pyelolithotomy with DJ Stent applied. The operating time was improving in each procedure, with average time was 110 minutes, VAS at the first day post-operative was 1-2, a drain was removed on the second day, one of them was extended until the sixth day, most patients was discharged on postoperative day 3. All patients were stented for 3 to 4 weeks; The stents were removed with office cystoscopy. All patients were stone free on follow-up imaging.